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The American Equity Underwriters, Inc. The American Equity Underwriters, Inc.
Longshore Insider
Summary of Key Provisions - Part I
Oct 28, 2014 - Jack Martone, The American Equity Underwriters, Inc.
Maximum/Minimum Weekly Compensation Rates

10/01/2014 – 09/30/2015 – $1,377.02/$344.26

10/01/2013 – 09/30/2014 – $1,346.68/$336.67

10/01/2012 – 09/30/2013 – $1,325.18/$331.30

10/01/2011 – 09/30/2012 – $1,295.20/$323.80

Types of Disability – Weekly Compensation Rate

Permanent Total (PTD) @ 2/3 x Average Weekly Wage (AWW) (10/1 annual adjustment)

Temporary Total (TTD) @ 2/3 x AWW

Permanent Partial (PPD)

Loss of Wage Earning Capacity (LWEC) @ 2/3 (AWW – post injury WEC)

Scheduled Award (Sec. 8(c)) @ 2/3 x AWW x scheduled # of weeks

Survivor’s – 50% x AWW for one (widow(er) or child) (10/1 annual adjustment)

50% x AWW plus 16 2/3 x AWW for widow(er) and child(ren)

20%-25% for dependent parents, grandparents, brothers, sisters if no widow, widower, or children

Examples of Sec. 8(c) schedule

100% of arm = 213 weeks

100% of leg = 288 weeks

100% hand = 244 weeks

100% foot = 205 weeks

100% loss of hearing – binaural = 200 weeks

Example – 20% permanent impairment to leg = 20% x 288 weeks x weekly compensation rate

Key Reporting Forms

LS-1, Request for Treatment

LS-202, Employer’s First Report of Injury

LS-206, Report of First Payment

LS-207, Notice of Controversion

LS-208, Notice of Final Payment

LS-203, Claim for Compensation

LS-18, Pre-Hearing Statement

LS-200, Report of Earnings

LS-262, Claim for Death Benefits

LS-201, Notice of Injury

Concurrent Jurisdiction

Concurrent States – AL, AK, CA, CT, DE, GA, IL, MA, MI, MN, MO, NC, NY, RI, SC, TN, WV, WI

Exclusive States – FL, HI, IN, KY, LA, ME, MD, MS, NJ, OH, OK, OR, PA, TX, VA, WA

Longshore Act extensions

Defense Base Act – 42 U.S.C. 1651

Outer Continental Shelf Lands Act – 43 U.S.C. 1331

Nonappropriated Fund Instrumentalities Act – 5 U.S.C. 8171

Time Limits for Filing a Claim

Sec. 913(a) – claim must be filed within one year of the awareness of the relationship between the injury or death and employment

Sec. 913(b)(2) – claim for occupational disease must be filed within two years

Delayed Running Times for Filing a Claim

State Act claim being paid – Sec. 13(a) (BRB case law)

Lawsuit terminated – Sec. 913(d)

No Form LS-202 filed by employer – Sec. 930(f)

Incompetent or minor claimant – Sec. 913(c)

While voluntary compensation is being paid, one year from last payment – Sec. 913(a)

No time limit – sec. 49 discrimination claims – Sec. 948(a)

No time limit – claims for medical treatment

Penalties

LS-202, First Report of Injury – must be filed within 10 days – penalty up to $11,000 per occurrence

Late payment of compensation – 10% – Sec. 914(e)

Late payment of compensation under an Award – 20% – Sec. 914(f)

Failure to insure – up to $10,000

Compliance

Sec. 904(a) – every employer must insure the payment of compensation; if subcontractor fails to insure, then contractor liable

Sec. 905(a) – if employer fails to insure, the injured employee has an election of remedies (tort or compensation)

Sec. 932 – USL&H insurance carrier must be authorized by U.S. Department of Labor

Sec. 932 – USL&H self-insurer must be authorized by U.S. Department of Labor

Sec. 938(a) – criminal liability, and joint and several liability for corporate officers

Exclusions

Jones Act crewmembers – Sec. 932(3)(G)

Government employees – federal, state, local

Recreational vessel amendment – check with an AEU expert

1984 amendment exclusions – Secs. 902(3)(A)-(F) – check with an AEU expert

Intoxication – sole cause – Sec. 903(c) – check with an AEU expert

Willful intent to injure or kill – 903(c) – check with an AEU expert

Small vessel facility exemption – Sec. 903(d) – check with an AEU expert

Next – Part Two – What to do if an accident occurs


ABOUT THE AUTHOR

John A. (Jack) Martone served for 27 years in the U.S. Department of Labor, Office of Workers’ Compensation Programs, as the Chief, Branch of Insurance, Financial Management, and Assessments and Acting Director, Division of Longshore and Harbor Workers’ Compensation. Jack joined The American Equity Underwriters, Inc. (AEU) in 2006, where he serves as Senior Vice President, AEU Advisory Services and is the moderator of AEU's Longshore Insider.
 
The opinions and comments expressed in this article are those of the authors and do not reflect the opinion of ALMA, AEU or AmWINS. None of ALMA, AEU, AmWINS or the authors are responsible for any inaccuracy of content or for any loss or damages incurred by any party as a result of reliance on information contained in this article. Content may not be published or reproduced without the written consent of the authors. Prior articles may not be updated for accuracy as pertinent information changes over time. The Longshore Insider is intended to provide general information about the industry and should not be construed as legal advice.
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